Survey Text

1999
1998
1997
1995
1994
1993
top
1999
Survey form view entire document:  text  image

ADS.065

FR: SHOW CARD A18

[If ADS.020 = (1) read:]
Not including your blood donations, which of these would you say were the reasons for your last AIDS test?

[Else read:]
Which of these would you say were the reasons for your last AIDS test?
Card A18
1. Just to find out/Worried that you are infected
2. Because a doctor asked you to
3. Because the Health Department asked you to
4. Because sex partner asked you to
5. For hospitalization or surgical procedure
6. To apply for health insurance or life insurance
7. To comply with guidelines for health workers
8. To apply for a new job
9. For military induction, separation, or during military service
10. For immigration
11. Because of pregnancy
12. For some other reason (Specify)
REATOT
(1) Just to find out/Worried that you are infected (ADS.070)
(2) Because a doctor asked you to (ADS.070)
(3) Because the Health Department asked you to (ADS.070)
(4) Because sex partner asked you to (ADS.070)
(5) For hospitalization or surgical procedure (ADS.070)
(6) To apply for health insurance or life insurance (ADS.070)
(7) To comply with guidelines for health workers (ADS.070)
(8) To apply for a new job (ADS.070)
(9) For military induction, separation, or during military service (ADS.070)
(10) For immigration (ADS.070)
(11) Because of pregnancy (ADS.070)
(12) Other reason - specify (ADS.067)
(13) Other reason - specify (ADS.068)
(97) Refused (ADS.070)
(99) Don't Know(ADS.070)

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ADS.067

Specify the additional reason for the last AIDS test.
REASPEC1 First reason: _______________

ADS.068

Specify the additional reason for the last AIDS test.
REASPEC2 Second reason: _______________

top
1998
Survey form view entire document:  text  image

ADS.065

FR: SHOW CARD A18

[If ADS.020 = (1) read:]
Not including your blood donations, which of these would you say were the reasons for your last AIDS test?

[Else read:]
Which of these would you say were the reasons for your last AIDS test?
Card A18
1. Just to find out/Worried that you are infected
2. Because a doctor asked you to
3. Because the Health Department asked you to
4. Because sex partner asked you to
5. For hospitalization or surgical procedure
6. To apply for health insurance or life insurance
7. To comply with guidelines for health workers
8. To apply for a new job
9. For military induction, separation, or during military service
10. For immigration
11. Because of pregnancy
12. For some other reason (Specify)
REATOT
(1) Just to find out/Worried that you are infected (ADS.070)
(2) Because a doctor asked you to (ADS.070)
(3) Because the Health Department asked you to (ADS.070)
(4) Because sex partner asked you to (ADS.070)
(5) For hospitalization or surgical procedure (ADS.070)
(6) To apply for health insurance or life insurance (ADS.070)
(7) To comply with guidelines for health workers (ADS.070)
(8) To apply for a new job (ADS.070)
(9) For military induction, separation, or during military service (ADS.070)
(10) For immigration (ADS.070)
(11) Because of pregnancy (ADS.070)
(12) Other reason - specify (ADS.067)
(13) Other reason - specify (ADS.068)
(97) Refused (ADS.070)
(99) Don't Know(ADS.070)

[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

ADS.067

Specify the additional reason for the last AIDS test.
REASPEC1 First reason: _______________

ADS.068

Specify the additional reason for the last AIDS test.
REASPEC2 Second reason: _______________

top
1997
Survey form view entire document:  text  image

ADS.065

FR: SHOW CARD A18

[If ADS.020 = (1) read:]
Not including your blood donations, which of these would you say were the reasons for your last AIDS test?

[Else read:]
Which of these would you say were the reasons for your last AIDS test?
Card A18
1. Just to find out/Worried that you are infected
2. Because a doctor asked you to
3. Because the Health Department asked you to
4. Because sex partner asked you to
5. For hospitalization or surgical procedure
6. To apply for health insurance or life insurance
7. To comply with guidelines for health workers
8. To apply for a new job
9. For military induction, separation, or during military service
10. For immigration
11. Because of pregnancy
12. For some other reason (Specify)
REATOT
(1) Just to find out/Worried that you are infected (ADS.070)
(2) Because a doctor asked you to (ADS.070)
(3) Because the Health Department asked you to (ADS.070)
(4) Because sex partner asked you to (ADS.070)
(5) For hospitalization or surgical procedure (ADS.070)
(6) To apply for health insurance or life insurance (ADS.070)
(7) To comply with guidelines for health workers (ADS.070)
(8) To apply for a new job (ADS.070)
(9) For military induction, separation, or during military service (ADS.070)
(10) For immigration (ADS.070)
(11) Because of pregnancy (ADS.070)
(12) Other reason - specify (ADS.067)
(13) Other reason - specify (ADS.068)
(97) Refused (ADS.070)
(99) Don't Know(ADS.070)

[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

ADS.067

Specify the additional reason for the last AIDS test.
REASPEC1 First reason: _______________

ADS.068

Specify the additional reason for the last AIDS test.
REASPEC2 Second reason: _______________

top
1995
Survey form view entire document:  text  image

Hand card A3. Read categories if telephone interview.
CARD A3
1. Just to find out/Worried that you are infected
2. Because a doctor asked you to
3. Because the Health Department asked you to
4. Because a sex partner asked you to
5. For hospitalization or a surgical procedure
6. To apply for health or life insurance
7. To comply with guidelines for health workers
8. To apply for a new job
9. For military induction, separation or during military service
10. For immigration
11. For some other reason - (Please specify)

18. Which of these would you say were the reasons for your (last) AIDS blood test (NOT including blood donations)? (Just tell me the number of your answers.)
(Anything else?)
Mark (X) all that apply.

01[] Just to find out/Worried that you are infected
02[] Because a doctor asked you to
03[] Because the Health Department asked you to
04[] Because a sex partner asked you to
05[] For hospitalization or a surgical procedure
06[] To apply for health or life insurance
07[] To comply with guidelines for health workers
08[] To apply for a new job
09[] For military induction, separation or during military service
10[] For immigration
11[] For some other reason - Specify
______
97[] Refused
98[] DK

top
1994
Survey form view entire document:  text  image

HAND CARD A3. Read categories if telephone interview.
CARD A3
1. Just to find out/I am worried that I am infected
2. Because a doctor asked you to
3. Because the Health Dept. asked you to
4. Because a sex partner asked you to
5. For hospitalization or a surgical procedure
6. To apply for health or life insurance
7. To comply with guidelines for health workers
8. To apply for a new job
9. For military induction, separation or during military service
10. For immigration
11. For some other reason (Please specify the other reason or reasons)

18. Which of these would you say were the reasons for your (last) AIDS blood test (NOT including blood donations)? (Just tell me the numbers of your answers.)
(Anything else?)
Mark (X) each that applies.

[] 01 Just to find out/I am worried that I am infected
[] 02 Because a doctor asked you to
[] 03 Because the Health Department asked you to
[] 04 Because a sex partner asked you to
[] 05 For hospitalization or a surgical procedure
[] 06 To apply for health or life insurance
[] 07 To comply with guidelines for health workers
[] 08 To apply for a new job
[] 09 For military induction, separation or during military service
[] 10 For immigration
[] 11 For some other reason (Specify) ____
[] 97 Refused
[] 99 DK

top
1993
Survey form view entire document:  text  image

HAND CARD C. Read categories if telephone interview.
CARD C
01. Just to find out if you were infected
02. For hospitalization or a surgical procedure
03. To apply for health insurance
04. To apply for life insurance
05. To comply with guidelines for health workers
06. To comply with regulations for other type(s) of work
07. To apply for a new job
08. For military induction or military service
09. For immigration
10. Because a doctor asked you to
11. Because the Health Dept. asked you to
12. Because a sex partner asked you to
13. Because it was part of the blood donation process
98. For some other reason (Please specify the other reason or reasons)

19. Which of these would you say were the reasons for your (last) AIDS blood test (NOT including blood donations)? (Just tell me the numbers of your answers.)
(Anything else?)
Mark (X) each that applies.

01 [] Just to find out if you were infected
02 [] For hospitalization or a surgical procedure
03 [] To apply for health insurance
04 [] To apply for life insurance
05 [] To comply with guidelines for health workers
06 [] To comply with regulations for other type(s) of work
07 [] To apply for a new job
08 [] For military induction or military service
09 [] For immigration
10 [] Because a doctor asked you to
11 [] Because the Health Dept. asked you to
12 [] Because a sex partner asked you to
13 [] Because it was part of the blood donation process
98 [] For some other reason -- Specify -- ____
97 [] Refused
99 [] DK